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Fwm 668 DEMRTYEMT Of TNE TREASURY-INTERMAI REVENUE SERYICf For Optior?aJ ~/se By Recording OHice
IREV. 12•7~) NOTICE Of FEOERAL TAX LIEN UNDER INTERNAI REVENUE LAWS FIlEO ANO NECOROEO
DISTRICT ' SERIAL NUMBER ~ fT.lUC1E COUNTY f~A. .
aC:~~SQItv'ILI,E 3~K) CtERK C RCUIT COURT
Pursuant to the provisions of Sections 6321. 6322, and 6323 of the internal Revenue pECORD VE~IFIED
Code, notice is hereby given that there have been assessed under the internal Revenue laws ~'n f~C
of the United States agai~st the following-named taxpayer, taxes (inctuding inte~est and 0 _
penalties) which after demand for payment thereof remain unpaid, and that by virtue of _ ;
the above-mentioned statutes the amount of said taxes, together with penalties, interest,
and costs that may accrue in addition thereto, is a lien in favor of the United States upon
all p~operty and rights to property belonging to said taxpayer.
NAME OF TAXPAYER
=~I1Y1~~+ P:Cv~.1'v~ ~11
T 3~l`7~
RESIDENCE
'~ox £~77
"t . Pierce, 331_~2
UNPAID BALANCE
KtND OF TAX TAX PERIOD ENOED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT
(al (bl lcl (dl lel
1 ~i:C-17 730^ - 7~03 1-2 ~-7' 2i:1-30-J30~: 15, 21 ~.3^
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~ PLACE OF FIUNG CiPTr. or ~ir^ui~ ~oux~..
~ S ~ucie C ow^•tv TOTAL S ~ 5, 21 33 ~
; Ft. Pierce, rL 331;~0
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~ V'11TNESS my hand at ` Qo''.~'ie~ _ , on this,
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~ the 2 r~iay of J~'u'~"~ , 1g 7`~
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SIGNAT E TITLE
~evenue Cfficer
~ (NO Certificate o~ otficer auMOri:ecf by law to [ake acknow{edgmer.ts is not essential to the vsfidity oi Notice ot Federal Tsx lien G.C.7N. ` 5
~ 2611 . C.B. 1950 1. 1?5.) A~ Z~ p~r,f
PART 1- To be retained by recording o(fice F!'
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